Franchuk M. Optimization of treatment for gout patients with obesity and kidney damage: stratification of risk factors, prediction and correction.

The aim of the study was to find predictors and risk factors for the development of kidney damage in patients with chronic gouty arthritis with obesity by identifying the relationships between the clinical characteristics of the disease and concomitant conditions. Based on the detection of elevated levels of microproteins in the urine, in 56,3 % patients was detected subclinical kidney damage, which revealed significant correlations between microproteinuria and hyperuricemia (r1 = 0,85; r2 = 0,73), hypouricosuria (r1 = -0,79; r2 = -0,63), decreased clearance of uric acid (r1 = -0,67; r2 = -0,56), hypercholesterolemia (r1 = 0,39; r2 = 0,44), hypertriglyceridemia (r1 = 0,84; r2 = 0,78), elevated levels of low density lipoproteins (r1 = 0,77; r2 = 0,79). Also, the correlation between kidney damage and concomitant arterial hypertension (r = 0,81), diabetes mellitus (r = 0,59) has been established. Approbation of the modified treatment proved its effectiveness, which was characterized by the best achievement of the hypouricemic (p = 0,033) and hyperuricosuric (p<0,001) effects. The level of microalbumin and a1-microglobulinuria was significantly (p1 = 0,022 and p2 = 0,002) decreased and reached normal values ??for modified treatment.